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[The termination of auricular flutter by noninvasive programmed electrical stimulation using a permanent AAI-mode
J Saucedo1, P Iturralde, F Attie
1Departamento de Electrocardiografía y Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez (INCICH), México, D.F.
Archivos Del Instituto De Cardiologia De Mexico
|July 1, 1993
Summary
A teenage boy with an atrial septal defect experienced atrial flutter post-surgery. Noninvasive programmed stimulation successfully restored normal sinus rhythm using his existing pacemaker.
Area of Science:
- Cardiology
- Electrophysiology
- Pediatric Medicine
Background:
- Atrial septal defect (ASD) closure is a common pediatric cardiac procedure.
- Post-procedural arrhythmias can occur following ASD repair.
- Atrial flutter is a potential complication after cardiac interventions.
Observation:
- A 15-year-old boy developed atrial flutter type I three years after direct ASD closure.
- Electrical cardioversion resulted in sinus bradycardia and a ventricular escape rhythm.
- Epicardial pacing was initiated in AAI mode due to the escape rhythm.
Findings:
- A subsequent episode of atrial flutter was successfully terminated.
- Noninvasive programmed stimulation was utilized for termination.
- The patient's previously implanted pacing system facilitated the intervention.
Implications:
- This case highlights the possibility of late-onset atrial flutter after ASD closure.
- Noninvasive programmed stimulation can be an effective strategy for managing recurrent arrhythmias in pediatric patients.
- Utilizing existing pacing systems offers a minimally invasive approach to arrhythmia termination.